The Fiber Gap and the Disappearing Gut Microbiome: Implications for Human Nutrition
Edward C. Deehan Trends Endo Metab 2016 In Press Corrected Proof
Lifestyle-Induced Microbiome Depletion and its Implications for Health
Humans have evolved with dense microbial populations that colonize their gastrointestinal tract and are integral to our biology, for example, through the provision of signals that aid the development of the immune system. There is convincing evidence from research in animal models that a disruption of this host–microbiome symbiosis leads to an increase in immune-mediated pathologies related to chronic non-communicable diseases (NCDs), such as obesity, cardiovascular disease, colon cancer, allergies, other atopic diseases (including asthma), autism, and autoimmune diseases.
A Low-Fiber Diet is a Key Driver of Microbiome Depletion
It is likely that a combination of factors (antibiotics, modern clinical practices, sanitation, dietary habits) have caused the decline in gut microbiome diversity. However, the only factor that has been empirically shown to be important is a diet low in microbiota-accessible carbohydrates (MACs), which are indigestible dietary carbohydrates that become available to the microbes that colonize the intestine.
Dietary Fiber Can Increase Microbiome Diversity and Prevent NCDs, but Consumption Is Not Sufficient
Dietary fiber and whole grains have been shown to increase diversity of the human fecal microbiota. Epidemiological studies further consistently show significant inverse associations between dietary fiber intake and microbiome-associated NCDs, and all-cause mortality, and research in animal disease models supports a beneficial role. Most human intervention studies are performed with daily amounts of daily fiber that are much lower than those consumed by our ancestors, and therefore might not lead to detectable physiological changes. Accordingly, moving African Americans to a traditional South African diet with a daily dose of 55 g of dietary fiber was efficient to improve markers of colon cancer within 2 weeks.
The available data indicate a considerable potential for dietary fiber to elevate microbiome diversity and prevent NCDs, but consumption is on average only half of what is recommended in dietary guidelines, which is referred to as the ‘fiber gap.
What Can Be Done to Conserve and Restore the Human Microbiome?
Virtually all nutritional organizations encourage consumption of dietary fiber. Despite these efforts and a general understanding of the benefits, average dietary fiber intake remains low – thus changes in dietary recommendations alone are unlikely to result in significant changes in consumer behavior.